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Psychiatric comorbidity: Differential characteristics and outcome amongst single and dual diagnosis psychiatric patients

Coclami, T. (2006). Psychiatric comorbidity: Differential characteristics and outcome amongst single and dual diagnosis psychiatric patients. (Unpublished Doctoral thesis, City, University of London)


The present project is a prospective investigation including follow-up designed to (i) compare and to evaluate the differential characteristics of drug-abusing and non-drug-abusing psychiatric patients who were voluntarily or involuntarily admitted in a Greek Psychiatric clinic from 1996 to 1998 in order to explore the roles of demographic and clinical variables in the course of their illness, (ii) identify potential outcome predictors for patients with or without comorbidity.

800 patients participated in this project, classified according whether they were diagnosed with single psychiatric disorder (Group 1, 620 patients, 77.5%) or dual diagnosis (Group 2, 180 patients, 22.5%).

In comparison to psychiatric patients who do not abuse substances, dual diagnosis patients had differential demographic characteristics and poorer outcome. Dual diagnosis patients were younger, more often males with earlier onset of illness than the single diagnosis patients. Long Duration of Untreated Mental Illness and high scores of EE (Expressed Emotion) were common negative predictors of outcome for both groups. The number of psychiatric episodes (Polyepisodic) and poor Premorbid Adjustment were the strongest Group 1 predictors of outcome. Schizophrenic diagnosis and divorced marital status with significant levels of loneliness appeared to be the best Group 2 predictors of outcome. In both Groups, the majority of relapses happened within one year of remission while the combination of pharmacological and psychosocial therapies was associated with a more favourable outcome than medication alone.

These findings provide further confirmatory evidence of the poor outcome in dual diagnosis population and point to important differences in demographic and clinical variables across patients with and without psychiatric comorbidity.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences > Psychology
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
Doctoral Theses
[thumbnail of Coclami thesis 2006 PDF-A.pdf]
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